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Individual

DR. JOSHUA BOUDEMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHARMD

Contact information

Practice address
3527 CHOUTEAU AVE, SAINT LOUIS, MO 63103-2915
(314) 771-2900
(314) 771-2955
Mailing address
3527 CHOUTEAU AVE, SAINT LOUIS, MO 63103-2915
(314) 771-2900
(317) 771-2955

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
051.295447
IL
183500000X
Pharmacist
Primary
2011026558
MO
183500000X
Pharmacist
PS60070
FL

Other

Enumeration date
11/04/2011
Last updated
12/19/2022
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